Massachusetts is requiring insurers to pay twice as much for COVID-19 vaccination as most other states
“Reimbursement rates to providers should not be a barrier."
While the COVID-19 vaccine may be free for Massachusetts residents, Gov. Charlie Baker’s administration has agreed to reimburse providers for vaccinations at twice the rate as the federal government and most other states — and they’re requiring private insurers to do the same.
The Boston Globe reported Monday night that the Baker administration made a little-noticed rule change in December to reimburse vaccine providers, from hospitals to mass vaccination sites, a total of $90 for administering the two-dose Pfizer and Moderna vaccines to anyone covered by the state’s Medicaid program, MassHealth, or by private insurance. That’s compared to the $45 rate set by the federal Medicare program and the vast majority of other states.
The move was first announced in a bulletin to providers in January.
State officials say the increased rates are part of the administration’s plan to “vaccinate as many residents as possible in the most efficient and equitable manner.”
“Reimbursement rates to providers should not be a barrier,” Brooke Karanovich, a spokeswoman for the Executive Office of Health and Human Services, told the Globe.
The state’s hospital association is cheering the move, after some leaders reportedly argued that the $45 rate wasn’t enough to cover the amount of outreach involved with the effort to vaccinate the most vulnerable groups.
And while private insurers will be forced to pay more, they’re going along with the rule for now — though small business advocates have expressed some concern about the downstream effect on premiums.
According to the Globe, the state has not set a rate for the one-shot Johnson & Johnson vaccine.
The coronavirus vaccines are free for all individuals, though some providers may ask for insurance information so they can be reimbursed. That said, insurance isn’t required, and the federal government has agreed to reimburse providers for the cost of administering the vaccine to uninsured individuals.
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